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Chapter 9. Integrative Management of Anxiety-Related Conditions
MULTIPLE CHOICE
1. A patient who was savagely attacked by a bear has no memory of the event. Which
statement best explains the patients inability to remember the attack?
a. The woman lost consciousness and was not cognitively aware of what happened during the
attack
b. The brain has produced a chemical anemia that will repress the memories of the attack
indefinitely.
c. The patient is unconsciously using a defense mechanism to protect against the repeated
memory of the attack.
d. It is a temporary suppression of the attack; her memory will return when she is physically and
emotionally ready to handle the memories.
ANS: C
Defense mechanisms are used unconsciously to protect us from threats to the physical,
mental, and social aspects of ourselves. The memory of the event may or may not come back
but this is not generally related to the patients ability to handle the memories. Memory may
be lost or impaired as a result of brain trauma but not as likely from a chemical alteration.
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2. Which assessment finding exhibited by a patient being assessed for posttraumatic stress
disorder (PTSD) would be considered a defining behavior and support such a diagnosis?
a. Can describe the attack in great detail b. Experiences dramatic swings in affect
c. Describes vivid flashbacks of being attacked
d. Is preoccupied with the need to tell someone about the attack
ANS: C
One defining behavior that is seen when an individual has PTSD is that the person re-
experiences the traumatic event. This takes place by having recurrent and intrusive disturbing
recollections of the trauma, including thoughts, images, or perceptions about the incident. The
person sometimes experiences recurrent dreams of the incident and acts or feels as though the
event was recurring in the present (flashback). Generally the PTSD patient cannot remember
all the details of the trauma nor are they particularly interested in re-telling the events of the
trauma. The patient generally has a very limited range of affect.
3. What is the basis for assessing a male patient who is agoraphobic for panic attacks?
a. Men are more likely to experience panic attacks.
b. An overwhelming number of agoraphobic patients also have panic attacks.
c. Patients are often unaware that the symptoms they are experiencing are those of panic.
d. Panic attacks are generally the cause of a patient developing phobias like agoraphobia.
ANS: B
Almost all patients who present with agoraphobia in clinical samples have a current diagnosis
or history of panic disorder. Males are not more likely than females to experience panic
attacks. Patients are not usually unaware of panic attack symptoms. Panic attacks dont cause,
but are often triggered by, phobias.
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4. Discharge preparation for a patient includes the administration of the Hamilton Anxiety
Scale
(HAS). When asked by the patient to explain the purpose of the assessment the nurse
responds:
a. It is an assessment tool used to evaluate the symptoms of anxiety. b. The tool is used to
help confirm the diagnosis of anxiety disorder.
c. This tool helps determine if your symptoms have improved with treatment. d. It helps
identify the presence of any other disorder associated with anxiety.
ANS: C
The HAS is a valid and time-tested tool that gives the most objective measure of the degree to
which anxiety has been effectively treated. The HAS does not evaluate for symptoms of
anxiety or act as a diagnosis tool for anxiety or another other associated disorder.
5. A patient is admitted for treatment for persistent, severe anxiety. Which nursing diagnosis
would help effectively direct patient care?
a. Disturbed sensory perception related to narrowed perceptual field b. Risk for injury
related to closed perception
c. Hopelessness related to total loss of control
d. Risk for other-directed violence related to combative behavior
ANS: A
A narrowed perceptual field occurs with severe anxiety; therefore this diagnosis should be
considered. Data are not present to support the other diagnoses.
6. The patient was an awkward child who was ridiculed by his father for his inability to catch
a ball. As an adult, the patient developed panic attacks at the time his company established
after- work team sporting activities. Which data discussed during the nursing interview
provides insight to the possible cause of this anxiety disorder when applying the behavioral
model?
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Chapter 9. Integrative Management of Anxiety-Related Conditions
MULTIPLE CHOICE
1. A patient who was savagely attacked by a bear has no memory of the event. Which
statement best explains the patients inability to remember the attack?
a. The woman lost consciousness and was not cognitively aware of what happened during the
attack
b. The brain has produced a chemical anemia that will repress the memories of the attack
indefinitely.
c. The patient is unconsciously using a defense mechanism to protect against the repeated
memory of the attack.
d. It is a temporary suppression of the attack; her memory will return when she is physically and
emotionally ready to handle the memories.
ANS: C
Defense mechanisms are used unconsciously to protect us from threats to the physical,
mental, and social aspects of ourselves. The memory of the event may or may not come back
but this is not generally related to the patients ability to handle the memories. Memory may
be lost or impaired as a result of brain trauma but not as likely from a chemical alteration.
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y ut
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ismillye@
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, lOMoAR cPSD| 14985576
2. Which assessment finding exhibited by a patient being assessed for posttraumatic stress
disorder (PTSD) would be considered a defining behavior and support such a diagnosis?
a. Can describe the attack in great detail b. Experiences dramatic swings in affect
c. Describes vivid flashbacks of being attacked
d. Is preoccupied with the need to tell someone about the attack
ANS: C
One defining behavior that is seen when an individual has PTSD is that the person re-
experiences the traumatic event. This takes place by having recurrent and intrusive disturbing
recollections of the trauma, including thoughts, images, or perceptions about the incident. The
person sometimes experiences recurrent dreams of the incident and acts or feels as though the
event was recurring in the present (flashback). Generally the PTSD patient cannot remember
all the details of the trauma nor are they particularly interested in re-telling the events of the
trauma. The patient generally has a very limited range of affect.
3. What is the basis for assessing a male patient who is agoraphobic for panic attacks?
a. Men are more likely to experience panic attacks.
b. An overwhelming number of agoraphobic patients also have panic attacks.
c. Patients are often unaware that the symptoms they are experiencing are those of panic.
d. Panic attacks are generally the cause of a patient developing phobias like agoraphobia.
ANS: B
Almost all patients who present with agoraphobia in clinical samples have a current diagnosis
or history of panic disorder. Males are not more likely than females to experience panic
attacks. Patients are not usually unaware of panic attack symptoms. Panic attacks dont cause,
but are often triggered by, phobias.
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ismillye@
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, lOMoAR cPSD| 14985576
4. Discharge preparation for a patient includes the administration of the Hamilton Anxiety
Scale
(HAS). When asked by the patient to explain the purpose of the assessment the nurse
responds:
a. It is an assessment tool used to evaluate the symptoms of anxiety. b. The tool is used to
help confirm the diagnosis of anxiety disorder.
c. This tool helps determine if your symptoms have improved with treatment. d. It helps
identify the presence of any other disorder associated with anxiety.
ANS: C
The HAS is a valid and time-tested tool that gives the most objective measure of the degree to
which anxiety has been effectively treated. The HAS does not evaluate for symptoms of
anxiety or act as a diagnosis tool for anxiety or another other associated disorder.
5. A patient is admitted for treatment for persistent, severe anxiety. Which nursing diagnosis
would help effectively direct patient care?
a. Disturbed sensory perception related to narrowed perceptual field b. Risk for injury
related to closed perception
c. Hopelessness related to total loss of control
d. Risk for other-directed violence related to combative behavior
ANS: A
A narrowed perceptual field occurs with severe anxiety; therefore this diagnosis should be
considered. Data are not present to support the other diagnoses.
6. The patient was an awkward child who was ridiculed by his father for his inability to catch
a ball. As an adult, the patient developed panic attacks at the time his company established
after- work team sporting activities. Which data discussed during the nursing interview
provides insight to the possible cause of this anxiety disorder when applying the behavioral
model?
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